Intimate partner violence against women in rural Vietnam : prevalance, risk factors, health effects and suggestions for interventions

Abstract: Background: Vietnam has undergone a rapid transition in the past 20 years, moving towards a more equal situation for men and women. However, Confucian doctrine is still strong and little is known about men s violence against women within the Vietnamese family. Aim: To improve knowledge of intimate partner violence (IPV) in a Vietnamese context, by focusing on professionals and trusted community inhabitants explanations of the violence and their suggestions for preventive activities. Further, to present data on prevalence, risk factors and health effects and to suggest appropriate intervention and prevention activities. Method: Qualitative and quantitative data were collected in the rural district, Ba Vi in northern Vietnam in 2002. Five focus group discussions were held and face-to-face interviews following a questionnaire developed by WHO for violence research were performed. In the epidemiological part, 883 married/partnered women aged 17 60 were included. Bi- and multivariate analyses were undertaken, with effect modification analyses and calculation of attributable fractions and population attributable fractions. Main findings: In the explorative qualitative study, intimate partner violence was explained as interplay between individual and family-related factors and socio-cultural norms and practices where Confucian ideology exerted a strong influence (paper I). It further revealed that IPV was rarely discussed openly in the community and women subjected to violence kept silent. The epidemiological study revealed that out of the 883 married/partnered women, 30.9% had been subjected to physical violence in their lifetime, and 8.3% in the preceding year. For the combined exposure to physical and sexual violence, the corresponding figures were 32.7% and 9.2%. The most commonly occurring form was psychological abuse (lifetime 55.4%; past year 33.7%). Lifetime experience of sexual violence was reported by 6.6% of the women, and by 2.2% for previous year exposure. In the majority of cases, the violence was exerted as repeated acts (paper II). The risk factors found for lifetime and past year physical/sexual violence were women s low education, husbands low education, low household income and male polygamy. The pattern of factors associated with psychological abuse alone were husband s low professional status and women s intermediate level of education (paper II). Women who witnessed interparental violence during childhood were significantly more likely to report experience of physical and sexual intimate partner violence in their own relationship at adult age and they also displayed a more tolerant attitude towards violence (paper III). When health effects were investigated, itwas found that physical and sexual violence caused chronic pain, injuries and serious mental health problems such as sadness/depression and suicidal thoughts in exposed women (Paper IV). Conclusions: IPV is commonly occurring in rural Vietnam, more so among the low educated and in poorer households. Violence perpetration is a serious violation of women s human rights that causes long-term suffering in exposed women. These findings call for legal and policy actions. Collaboration between the health sector and other bodies at all levels, and with community leaders as spokesmen would help to improve openness and reduce society s tolerance of violence against women.